The overall goal of this PCCTR is to address three major barriers to increase capacity for CAM research at Michigan State University College of Osteopathic Medicine (MSUCOM): 1) the lack of standardized, objective instruments and measures for characterizing and optimizing osteopathic manipulative therapy (OMT) interventions, 2) the lack of visible ongoing OMT research programs and 3) the lack of research training of clinical faculty. The rationale for the three research projects is based on the overall hypothesis that OMT affects some aspects of sensory and/or motor functions of the musculoskeletal system. Thus, improvement in performance of such a system should serve as an objective outcome measure. In project one, a systems science approach will be applied to identify deficits in postural control of individuals with low back pain (LBP) and assess the effects of OMT on postural control. A parallel robot device, programmed to mimic unstable sitting on a half-cylinder, will be used to quantify balance and postural control before and after 4 weeks of OMT in a cross-over experimental design. Project two will investigate whether OMT can mitigate adverse effects from a sudden, unexpected trunk perturbation by resulting in a faster and more accurate response of the postural control system to such an event in patients in LBP. The speed of the control system and its accuracy will be quantified before and after 4 weeks of OMT in a cross-over experimental design. Project three will develop clinical research tools for the assessment of motor control of the head-neck system. Using a cross-over experimental design, these tools will then be applied to measure changes in position and force control of the head-neck system in patients with and without neck pain before and after 4 weeks of OMT.